Insurance

[Simpley_ke 201]

I'm with BCBS of Texas and there was no waiting or even asking. They said a big' date=' fat NO upfront. They won't pay a cent on any WLS here. I hope it's better up there in Wyoming. Good luck![/quote']

I have the same insurance as well and they approved me. Did you ask why they denied?

[ms.garcia 13]

Anyone on fb I can follow for support

[Nevermore 38]

Simply_ke,

They just said they don't cover it under a diagnosis of "morbid obesity". I told them that's not my diagnosis and they said I can appeal, but they don't accept any other diagnosis for wls.

[caligirl3 73]

Anyone on fb I can follow for support

look for me: lissavsg

Simply_ke,

They just said they don't cover it under a diagnosis of "morbid obesity". I told them that's not my diagnosis and they said I can appeal, but they don't accept any other diagnosis for wls.

That confuses me... I have no idea what it means... So, if you have morbid obesity ONLY they won't cover it, and without morbid obesity it won't be covered? Sounds like maybe they're looking for co-morbidities as well?

[ms.garcia 13]

look for me: lissavsg

That confuses me... I have no idea what it means... So' date=' if you have morbid obesity ONLY they won't cover it, and without morbid obesity it won't be covered? Sounds like maybe they're looking for co-morbidities as well?[/quote']

Yes your correct they want the co-mobidities....ie: sleep apnea diabetes with meds...etc.

[caligirl3 73]

Ugh vent...

So I called my insurance to check on my approval... They said that the dr. office put the surgery date out to 1/24/14, so they're not in a hurry to process it. ARG! I called my coordinator, she said that isn't true, they process as normal whatever the date. I told her they asked me to have the dr. resubmit with a closer/sooner date of procedure so it would be processed sooner... She called insurance, moved the date up to 12/2/13 and now we're waiting for approval again...

I let my coordinator know that my insurance was changing on the first of the year due to insurance regulation changes with the ACA, and I'm not sure my employer will be covering WLS benefit any longer. It I don't get the surgery in Nov/Dec I may not be able to proceed! She assured me as soon as the approval comes through I could be scheduled in a matter of weeks. Come on insurance!!!!!!!!!

[Nevermore 38]

When I talked to them, I asked about the co-morbidities as well. They said they won't cover it -at all-... under no circimstances... They didn't care about co-mordbities because the original diagnosis is morbid obesity with co-morbidities. It didn't really apply to me but I was trying to find out under what circumstances I could get some help.

[Nevermore 38]

caligirl3,

Saying a prayer for you, hun! It will work out!

[caligirl3 73]

When I talked to them, I asked about the co-morbidities as well. They said they won't cover it -at all-... under no circimstances... They didn't care about co-mordbities because the original diagnosis is morbid obesity with co-morbidities. It didn't really apply to me but I was trying to find out under what circumstances I could get some help.

Man how totally frustrating! In that case, I'd probably be looking into Mexico if it were me.